Lin Tin-Kwang, Hsu Bo-Cheng, Li Yi-Da, Chen Chi-Hsien, Lin Jiunn-Wen, Chien Chen-Yu, Weng Chia-Ying
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Psychol Health. 2025 May;40(5):812-831. doi: 10.1080/08870446.2023.2265617. Epub 2023 Oct 8.
This study investigated the association between Type D personality and prognoses in stable coronary artery disease (CAD) patients by mode of endpoints, age, and methodological debates to explain substantial heterogeneity among Type D studies.
The prospective study was designed to recruit 590 stable CAD patients in Taiwan. Main outcome measures: Demographic and clinical characteristics, and the 14-item Type D scale-Taiwanese version were recorded at discharge.
Hierarchical logistic regression analyses showed, regardless of the methodological debates, Type D personality was significantly associated with MACEs though not non-cardiac outcomes in stable CAD patients after adjusting for possible confounders. Furthermore, Type D personality was especially associated with MACEs in stable CAD patients with younger age (<65 y), rather than older age (≥65 y). Subgroup analysis also showed the adverse effect of Type D personality on MACEs was larger among males, those living in the rural region, those with PTCA or stent, those with heart failure, hypertension, diabetes, and those who were smokers.
Regardless of whether the methodological debate is dichotomous or continuous, Type D personality was significantly associated with MACEs in stable CAD patients, some of whom had younger age, were males, smokers, or had comorbidities.
本研究通过终点模式、年龄和方法学争论，调查D型人格与稳定型冠状动脉疾病（CAD）患者预后之间的关联，以解释D型人格研究之间存在的显著异质性。
这项前瞻性研究旨在招募590名台湾稳定型CAD患者。主要结局指标：出院时记录人口统计学和临床特征，以及14项D型人格量表台湾版。
分层逻辑回归分析显示，无论方法学争论如何，在调整可能的混杂因素后，D型人格与稳定型CAD患者的主要不良心血管事件（MACE）显著相关，但与非心脏结局无关。此外，D型人格在年龄较小（<65岁）而非年龄较大（≥65岁）的稳定型CAD患者中尤其与MACE相关。亚组分析还显示，D型人格对MACE的不良影响在男性、居住在农村地区的人、接受经皮冠状动脉腔内血管成形术（PTCA）或支架植入术的人、患有心力衰竭、高血压、糖尿病的人以及吸烟者中更大。
无论方法学争论是二分法还是连续法，D型人格与稳定型CAD患者的MACE显著相关，其中一些患者年龄较小、为男性、吸烟者或患有合并症。
